aspg-3-3921-1791419384 20261008002944 American Scientific Publishing Group admin@americaspg.com American Scientific Publishing Group Fusion: Practice and Applications FPA 2770-0070 2692-4048 2026 21 1 Karam Hatem Alkhater Department of Computer Engineering Techniques, College of Technical Engineering, University of Al Maarif, Al Anbar, 31001, Iraq; Department of Information & Communication Technology, College Mohana Shanmugam Department of Informatics, College of Computing and Informatics, Universiti Tenaga Nasional, Selangor, Malaysia Pritheega Magalingam Faculty of Artificial Intelligence, Universiti Teknologi Malaysia (UTM), Kuala Lumpur, Malaysia Normal false false false TR X-NONE AR-SA DefSemiHidden="false" DefQFormat="false" DefPriority="99" LatentStyleCount="371"> UnhideWhenUsed="true" QFormat="true" Name="heading 2"/> UnhideWhenUsed="true" QFormat="true" Name="heading 3"/> UnhideWhenUsed="true" QFormat="true" Name="heading 4"/> UnhideWhenUsed="true" QFormat="true" Name="heading 5"/> UnhideWhenUsed="true" QFormat="true" Name="heading 6"/> UnhideWhenUsed="true" QFormat="true" Name="heading 7"/> UnhideWhenUsed="true" QFormat="true" Name="heading 8"/> UnhideWhenUsed="true" QFormat="true" Name="heading 9"/> Name="index 1"/> Name="index 2"/> Name="index 3"/> Name="index 4"/> Name="index 5"/> Name="index 6"/> Name="index 7"/> Name="index 8"/> Name="index 9"/> UnhideWhenUsed="true" Name="toc 1"/> UnhideWhenUsed="true" Name="toc 2"/> UnhideWhenUsed="true" Name="toc 3"/> UnhideWhenUsed="true" Name="toc 4"/> UnhideWhenUsed="true" Name="toc 5"/> UnhideWhenUsed="true" Name="toc 6"/> UnhideWhenUsed="true" Name="toc 7"/> UnhideWhenUsed="true" Name="toc 8"/> UnhideWhenUsed="true" Name="toc 9"/> Name="Normal Indent"/> Name="footnote text"/> Name="annotation text"/> Name="header"/> Name="footer"/> Name="index heading"/> UnhideWhenUsed="true" QFormat="true" Name="caption"/> Name="table of figures"/> Name="envelope address"/> Name="envelope return"/> Name="footnote reference"/> Name="annotation reference"/> Name="line number"/> Name="page number"/> Name="endnote reference"/> Name="endnote text"/> Name="table of authorities"/> Name="macro"/> Name="toa heading"/> Name="List"/> Name="List Bullet"/> Name="List Number"/> Name="List 2"/> Name="List 3"/> Name="List 4"/> Name="List 5"/> Name="List Bullet 2"/> Name="List Bullet 3"/> Name="List Bullet 4"/> Name="List Bullet 5"/> Name="List Number 2"/> Name="List Number 3"/> Name="List Number 4"/> Name="List Number 5"/> Name="Closing"/> Name="Signature"/> UnhideWhenUsed="true" Name="Default Paragraph Font"/> Name="Body Text"/> Name="Body Text Indent"/> Name="List Continue"/> Name="List Continue 2"/> Name="List Continue 3"/> Name="List Continue 4"/> Name="List Continue 5"/> Name="Message Header"/> Name="Salutation"/> Name="Date"/> Name="Body Text First Indent"/> Name="Body Text First Indent 2"/> Name="Note Heading"/> Name="Body Text 2"/> Name="Body Text 3"/> Name="Body Text Indent 2"/> Name="Body Text Indent 3"/> Name="Block Text"/> Name="Hyperlink"/> Name="FollowedHyperlink"/> Name="Document Map"/> Name="Plain Text"/> Name="E-mail Signature"/> Name="HTML Top of Form"/> Name="HTML Bottom of Form"/> Name="Normal (Web)"/> Name="HTML Acronym"/> Name="HTML Address"/> Name="HTML Cite"/> Name="HTML Code"/> Name="HTML Definition"/> Name="HTML Keyboard"/> Name="HTML Preformatted"/> Name="HTML Sample"/> Name="HTML Typewriter"/> Name="HTML Variable"/> Name="Normal Table"/> Name="annotation subject"/> Name="No List"/> Name="Outline List 1"/> Name="Outline List 2"/> Name="Outline List 3"/> Name="Table Simple 1"/> Name="Table Simple 2"/> Name="Table Simple 3"/> Name="Table Classic 1"/> Name="Table Classic 2"/> Name="Table Classic 3"/> Name="Table Classic 4"/> Name="Table Colorful 1"/> Name="Table Colorful 2"/> Name="Table Colorful 3"/> Name="Table Columns 1"/> Name="Table Columns 2"/> Name="Table Columns 3"/> Name="Table Columns 4"/> Name="Table Columns 5"/> Name="Table Grid 1"/> Name="Table Grid 2"/> Name="Table Grid 3"/> Name="Table Grid 4"/> Name="Table Grid 5"/> Name="Table Grid 6"/> Name="Table Grid 7"/> Name="Table Grid 8"/> Name="Table List 1"/> Name="Table List 2"/> Name="Table List 3"/> Name="Table List 4"/> Name="Table List 5"/> Name="Table List 6"/> Name="Table List 7"/> Name="Table List 8"/> Name="Table 3D effects 1"/> Name="Table 3D effects 2"/> Name="Table 3D effects 3"/> Name="Table Contemporary"/> Name="Table Elegant"/> Name="Table Professional"/> Name="Table Subtle 1"/> Name="Table Subtle 2"/> Name="Table Web 1"/> Name="Table Web 2"/> Name="Table Web 3"/> Name="Balloon Text"/> Name="Table Theme"/> Name="List Paragraph"/> Name="Intense Quote"/> Name="Subtle Emphasis"/> Name="Intense Emphasis"/> Name="Subtle Reference"/> Name="Intense Reference"/> UnhideWhenUsed="true" Name="Bibliography"/> UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/> Name="Grid Table 1 Light Accent 1"/> Name="Grid Table 6 Colorful Accent 1"/> Name="Grid Table 7 Colorful Accent 1"/> Name="Grid Table 1 Light Accent 2"/> Name="Grid Table 6 Colorful Accent 2"/> Name="Grid Table 7 Colorful Accent 2"/> Name="Grid Table 1 Light Accent 3"/> Name="Grid Table 6 Colorful Accent 3"/> Name="Grid Table 7 Colorful Accent 3"/> Name="Grid Table 1 Light Accent 4"/> Name="Grid Table 6 Colorful Accent 4"/> Name="Grid Table 7 Colorful Accent 4"/> Name="Grid Table 1 Light Accent 5"/> Name="Grid Table 6 Colorful Accent 5"/> Name="Grid Table 7 Colorful Accent 5"/> Name="Grid Table 1 Light Accent 6"/> Name="Grid Table 6 Colorful Accent 6"/> Name="Grid Table 7 Colorful Accent 6"/> Name="List Table 1 Light Accent 1"/> Name="List Table 6 Colorful Accent 1"/> Name="List Table 7 Colorful Accent 1"/> Name="List Table 1 Light Accent 2"/> Name="List Table 6 Colorful Accent 2"/> Name="List Table 7 Colorful Accent 2"/> Name="List Table 1 Light Accent 3"/> Name="List Table 6 Colorful Accent 3"/> Name="List Table 7 Colorful Accent 3"/> Name="List Table 1 Light Accent 4"/> Name="List Table 6 Colorful Accent 4"/> Name="List Table 7 Colorful Accent 4"/> Name="List Table 1 Light Accent 5"/> Name="List Table 6 Colorful Accent 5"/> Name="List Table 7 Colorful Accent 5"/> Name="List Table 1 Light Accent 6"/> Name="List Table 6 Colorful Accent 6"/> Name="List Table 7 Colorful Accent 6"/> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0in; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi; mso-ansi-language:TR;} The integration of blockchain technology and metaheuristic optimization has transformed healthcare systems by improving security, scalability, and data interoperability. Blockchain ensures decentralization, immutability, and privacy, making it a viable solution for electronic medical records (EMRs) and secure healthcare data management. Meanwhile, metaheuristic algorithms optimize blockchain networks by enhancing transaction efficiency, consensus mechanisms, and real-time medical data processing. This paper systematically reviews recent advancements in blockchain and metaheuristics for healthcare applications. We discuss existing privacy-preserving models, AI-driven optimization techniques, and hybrid consensus mechanisms, addressing their strengths and limitations. Through a structured methodology, we analyze research trends, security challenges, and computational bottlenecks. This study encompassed 300 research articles from nine global databases. Then, inclusion and exclusion criteria were applied, leading to the exclusion of 144 studies and the retention of 156 studies. Subsequently, quality assessments were conducted, resulting in the final inclusion of only 8 studies for data extraction. A three-phase methodology was followed: planning, conducting, and reporting. The studies covered the period from January 2020 to January 2025, and 10 evaluation questions were used to assess the quality of the studies. Our findings reveal that while blockchain enhances data security and interoperability, metaheuristic-driven AI further optimizes system efficiency. However, challenges such as scalability constraints, energy consumption, regulatory compliance, and AI-based cyber threats remain significant. Future research should focus on developing lightweight blockchain architectures, quantum- resistant cryptographic models, and federated AI-enhanced security frameworks to address these issues. By leveraging advanced blockchain and AI-driven metaheuristics, healthcare systems can achieve greater resilience, efficiency, and adaptive security. 2026 63 78 3921 https://creativecommons.org/licenses/by/4.0/ 10.54216/FPA.210105 https://www.americaspg.com/journal/3/article/3921 https://www.americaspg.com/storage/01753386092.pdf